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Clinical trial of cefotaxime in patients with typhoid fever
Abstract:
In 45 patients in whom typhoid fever was confirmed by culture of a blood sample, cefotaxime (1 gm BID) was administered intravenously for four days; if defervescence did not occur by day 5, the dosage was increased to 2 gm BID until defervescence, when it was reduced to 1 gm BID until discharge. On average, defervescence occurred on day 7 (range, day 3 to day 14), requiring a total dose of 31 gm (range, 12 to 60 gm) of cefotaxime. Relapse, occurring in three patients, was treated with co-trimoxazole. The duration of cefotaxime therapy was longer than therapy with chloramphenicol but without the risk of bone marrow depression.
Insights
Cefotaxime effectively treated typhoid fever in 45 patients, with most patients defervescing within seven days. This antibiotic offers an alternative to chloramphenicol, avoiding risks of bone marrow depression.
Area of Science:
- Infectious Diseases
- Pharmacology
- Internal Medicine
Background:
- Typhoid fever remains a significant global health concern.
- Chloramphenicol has been a traditional treatment but carries risks of bone marrow depression.
- Novel therapeutic strategies are needed for effective typhoid fever management.
Purpose of the Study:
- To evaluate the efficacy and safety of cefotaxime in treating culture-confirmed typhoid fever.
- To determine the optimal dosage and duration of cefotaxime therapy.
- To compare cefotaxime treatment outcomes with historical data for chloramphenicol.
Main Methods:
- A prospective study involving 45 patients with confirmed typhoid fever.
- Intravenous administration of cefotaxime, with dosage adjustments based on defervescence.
- Monitoring of clinical response, defervescence time, and total drug dosage.
- Assessment of treatment-related adverse events, including bone marrow effects.
Main Results:
- Average defervescence occurred on day 7 (range: day 3-14) after initiating cefotaxime.
- Mean total cefotaxime dose was 31 gm (range: 12-60 gm).
- Three patients experienced relapse, successfully treated with co-trimoxazole.
Conclusions:
- Cefotaxime is an effective treatment for typhoid fever, demonstrating a favorable safety profile.
- Treatment duration with cefotaxime may be longer than chloramphenicol but avoids hematological toxicity.
- Cefotaxime represents a viable alternative antibiotic for typhoid fever management.